Methods for treating diet-induced obesity by decreasing or inhibiting P2Y2 purinergic receptor expression or activity

ABSTRACT

The invention provides a method for treating or preventing diet-induced obesity in a subject comprising administering an agent in an effective amount so that expression or activity of the P2Y 2  receptor is decreased or inhibited in the subject thereby treating or preventing diet-induced obesity in the subject.

This application is a continuation-in-part of (under 35 U.S.C. § 111(a)), and claims the priority to (under 35 U.S.C. § § 120 and 365(c)), PCT application PCT/US2013/066932, with international filing date Oct. 25, 2013, which claims the benefit of the filing date of U.S. Ser. No. 61/795,815, filed Oct. 25, 2012, the entireties of which are hereby incorporated by reference into the present patent application.

The present invention was made with government support under Department of Veterans Affairs Merit Review Program, Grant No. BLRD 000591, and the facilities and resources at the VA Salt Lake City Health Care System. The Government has certain rights to this invention.

FIELD OF THE INVENTION

Blunting the activity of the P2Y₂ receptor results in a resistance to diet-induced obesity, an increased metabolic activity, and a better glucose tolerance. Therefore, compounds that inhibit the purinergic P2Y₂ receptor are useful for treating diet-induced obesity and metabolic disorders associated therewith, such as diabetes mellitus.

BACKGROUND OF THE INVENTION

Obesity is one of the major public health problems of the 21st century with significant consequences on health of the individuals and impact on the national economies. The most common cause of obesity is diet-induced, i.e., consumption of more calories than one can metabolize. In view of the rapidly growing number of obese people throughout the world, the global market for anti-obesity drugs is estimated to reach $3.4 billion by 2016. However, currently available drugs for the treatment of obesity have significant limitations in terms of safety, efficacy or both. Thus, there is a high unmet need for safe and efficacious medications for the prevention or treatment of obesity. This invention discloses a potential drug target for the treatment of diet-induced overweight or obesity. This approach involves increasing the metabolism of consumed excess calories, which may prove to be safer or tolerable than the other two approaches, namely suppression of the appetite or interfering with the absorption of fat in the intestines. It is possible to develop orally effective chemical compounds that selectively act at the disclosed target as potential anti-obesity drugs.

According to the World Health Organization, a Body Mass Index (BMI)>25 is overweight, and a BMI>30 is obesity. Overweight and obesity are no more the problems of high-income countries of the world. They are rapidly rising in low- and middle-income countries.

In 2008 the World Health Organization estimated that globally more than 1.4 billion adults were overweight; and the 2010 estimates showed that more than 40 million children under five years are overweight. Overweight and obesity are the fifth leading risk for global deaths, accounting for 2.8 million deaths each year. In fact, overweight and obesity are linked to more deaths worldwide than underweight.

Raised BMI is a major risk factor for cardiovascular and musculoskeletal disorders, and certain types of cancers, such as breast and colon cancers. In fact, 44% of the diabetic burden, 23% of the ischemic heart disease burden and between 7% and 14% of certain cancer burdens are attributable to overweight and obesity.

The global economic burden of overweight and obesity are not well established. But the numbers are more accurately available for the United States. Over the past 50 years the prevalence of obesity in the USA has almost tripled from 13% to 34%, with the percentage of Americans who are extremely or “morbidly” obese rising from 0.9 to 6. The estimated annual medical costs due to obesity are about $190 billion. The indirect costs due to overweight and obesity are also sky rocketing. For example, it is estimated that airlines incur about $5 billion annually for additional jet fuel needed to fly obese or heavier people as compared to the fuel needed to fly the same number of people based on the body weights prevalent in 1960s. Automobiles also consume extra gasoline amounting to about $4 billion to transport heavier people in the USA. The annual costs due to absenteeism among over weight and obese people are also very high. In fact, according to a study, the costs of obesity exceed those of smoking.

According to the World Health Organization, the fundamental cause of obesity and overweight is energy imbalance between calories consumed and calories expended. In recent decades globally there has been an increase in caloric intake and a decrease in the physical activity, driving the incidence of obesity high. Although supportive environments and communities resulting in consumption of healthy foods and regular physical activity are the best to prevent overweight and obesity, these do not happen often, in part because of the complex nature of modern day living.

Currently used modalities as well as the pipeline drugs for the prevention and/or treatment of obesity fall into the following three categories: (1) drugs that suppress appetite by acting on the brain (e.g., sibutramine (i.e., Reductil® and/or Meridia®); (2) drugs that boost body's metabolic rate (e.g., cannaboid receptor antagonists and Metformin); and (3) drugs that interfere with the body's ability to absorb specific nutrients in food, such as fat (e.g., Orlistat®, Xenical®, and/or Alii®).

Drugs that suppress the appetite by acting on the brain have severe side effects which are neurological and/or psychological in nature. For example, these drugs carry a risk of high blood pressure, faster heart rate, palpitation, restlessness, agitation, insomnia etc. Due to these limitations, drugs that suppress appetite have been withdrawn from the market by the FDA and approval of newer drugs has been made more stringent. Drugs that increase the body's metabolic rate have their own limitations, such as lack of consistent effect resulting in sustained loss of weight. Drugs that block absorption of dietary fat, cause oily stools (steatorrhea), abdominal pain and flatulence.

In view of the side effects with these therapies, combination therapies that target more than one pathway have been developed. However, these also have severe side effects and limitations, despite their efficacy in short-term treatment. Accordingly, there is a high unmet need for safe and effective medications for the prevention or treatment of overweight and obesity, which is expected to drive the anti-obesity market growth in the future. The invention described herein seeks to meet this need.

SUMMARY OF THE INVENTION

Provided herein are methods for selectively blocking the activity of the P2Y2 purinergic receptor for the prevention and/or treatment of diet-induced overweight or obesity. It was discovered that the genetic deletion of P2Y2 receptor results in resistance to the development of high-fat diet-induced obesity and the associated physical and molecular alterations in mice. The results described also suggest that the observed resistance in the P2Y2 receptor knockout mice was not due to reduced consumption of high-fat diet or lack of absorption of fat in the intestines, but may be due to the ability of the knockout mice to metabolize or “burn” the extra calories consumed in the diet more efficiently than the wild type mice. Accordingly, targeting P2Y2 receptor with specific pharmacological agents or drugs is a safe approach to prevent or treat diet-induced overweight or obesity.

In various embodiments, provided herein are methods for treating or preventing diet-induced obesity in a subject by administering an agent that blunts the expression or activity of the P2Y₂ receptor in the subject.

In some specific embodiments, the agent is a fusion protein or an agent that inhibits the P2Y₂ receptor. In specific embodiments, the agent is a selective P2Y₂ receptor antagonist, including but not limited to a non-nucleic acid small organic molecule. In one embodiment, the P2Y₂ receptor antagonist is a non-competitive P2Y₂ receptor antagonist. The non-competitive P2Y₂ receptor antagonist may be a non-selective non-competitive P2Y₂ receptor which may inhibit other members of the P2Y receptor family [Ralevic V, Burnstock G. 1998. Receptors for purines and pyrimidines. Pharmacol Rev 50:413-492] with no selectivity for P2Y₂ receptor, a selective non-competitive P2Y₂ receptor antagonist with a selectivity for P2Y₂ receptor or a specific non-competitive P2Y₂ receptor antagonist inhibiting the activity of only P2Y₂ receptor. Preferably, the non-competitive P2Y₂ receptor antagonist is a selective non-competitive P2Y₂ receptor antagonist. More preferably, the non-competitive P2Y₂ receptor antagonist is a specific non-competitive P2Y₂ receptor antagonist. Non-competitive P2Y₂ receptor antagonist may be flavonoids. Useful flavonoids may be isolated from plant sources [Ververidis F, Trantas E, Douglas C, Vollmer G, Kretzschmar G, Panopoulos N (October 2007). “Biotechnology of flavonoids and other phenylpropanoid-derived natural products. Part I: Chemical diversity, impacts on plant biology and human health”. Biotechnology Journal 2 (10): 1214-34], such as Calycopteris floribunda Lamk. (Combretaceae) [Mayer R. 1999. Calycopterones and calyflorenones, novel biflavonoids from Calycopteris floribunda. J Nat Prod 62:1274-1278], Leptospermum scoparium Forst. (Myrtaceae) [Mayer R. 1990. Flavonoids from Leptospermum scoparium. Phytochemistry 29:1340-1342; Mayer R. 1993. A β-hydroxychalcone from Leptospermum scoparium. Planta Med 59:269-271], and tangerine peels from Citrus reticulate ssp., Rutaceae [Chen J, Montamari A M, Widmer W W. 1997. Two new polymethoxylated flavones, a class of compounds with potential anticancer activity, isolated from cold pressed dancy tangerine peel oil solids. J Agric Food Chem 45:364-368], microorganisms genetically engineered to produce flavonoids [Hwang E I, Kaneko M, Ohnishi Y, Horinouchi S (May 2003). “Production of plant-specific flavanones by Escherichia coli containing an artificial gene cluster”. Appl. Environ. Microbiol. 69 (5): 2699-706; Trantas E, Panopoulos N, Ververidis F (2009). “Metabolic engineering of the complete pathway leading to heterologous biosynthesis of various flavonoids and stilbenoids in Saccharomyces cerevisiae”. Metabolic Engineering 11 (6): 355-366; Ververidis F, Trantas E, Douglas C, Vollmer G, Kretzschmar G, Panopoulos N (2007). “Biotechnology of flavonoids and other phenylpropanoid-derived natural products. Part 11: Reconstruction of multienzyme pathways in plants and microbes”. Biotechnology Journal 2 (10): 1235-491, and products of chemical or biochemical reactions leading to synthesis or modification of a flavonoid. In an embodiment, the non-competitive P2Y₂ receptor antagonist has an half maximal inhibitory concentration (IC₅₀) of below 100 μM, preferably below 35 μM, more preferably below 25 μM, even more preferably below 10 μM, even, even more preferably below 5 μM and most preferably below 1 μM. In one embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 35-100 μM. In a separate embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 25-35 μM. In another embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 10-25 μM. In another embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 5-10 μM. In a more preferred embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 1-5 μM. In a most preferred embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of less than 1 μM. In yet another preferred embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 between 0.1-1 μM. Examples of non-competitive P2Y₂ receptor antagonist include strobopinin, strobopinin-7-methyl ether, 2′-β-Dihydroxy-4′,6′-dimethoxy-3′-methylchalcone (or Oxo-Aurentiacin), kaempferol, heptamethoxylflavone, and tangeretin with chemical structures and additional flavonoids described in Kaulich M, Streicher F, Mayer R, Muller I, Muller C E. 2003. “Flavonoids—novel lead compounds for the development of P2Y₂ receptor antagonists”. Drug Development Research 59:72-81.

In one embodiment, the P2Y₂ receptor antagonist is a competitive P2Y₂ receptor antagonist. In one embodiment, the competitive P2Y₂ receptor antagonist may be a non-selective or slightly selective competitive P2Y₂ receptor antagonist. Examples of non-selective or slightly selective competitive P2Y₂ receptor antagonists include suramin (8,8′-[Carbonylbis[imino-3, l-phenylenecarbonylimino(4-methyl-3,1-phenylene)carbonylimino]]bis-1,3,5 naphthalenetrisulphonic acid) and Reactive Blue 2 (RB2) with an IC50 of between 5 μM and 35 μM [Kaulich M, Streicher F, Mayer R, Muller I, Muller C E. 2003. “Flavonoids—novel lead compounds for the development of P2Y₂ receptor antagonists”. Drug Development Research 59:72-81; Jacobson K A, Jayasekara, M P S, Costanzi S. 2012. “Molecular structure of P2Y receptors: mutagenesis, modeling, and chemical probes”. WIREs Membr Transp Signal 1:815-827; Jacobson K A. “P2X and P2Y receptors”. Tocris Bioscience Scientific Review Series, pp. 1-15]. In one embodiment, the competitive P2Y₂ receptor antagonist is a selective competitive P2Y₂ receptor antagonist. Examples of selective competitive P2Y₂ receptor antagonists include AR-C126313 and AR-C118925 comprising an IC50 of about 6 μM [Jacobson K A, Ivanov A A, de Castro S, Harden T K, Ko H. 2009. “Development of selective agonists and antagonists of P2Y receptors”. Purinergic Signalling 5:75-89; Meghani P. 2002. “The design of P2Y₂ antagonists for the treatment of inflammatory diseases”. 224^(th) ACS National meeting, Abstracts, Division of medicinal chemistry 12; Kindon N, Meghani P, Thom S (1998) World Pat. 98/54180; Kemp P A et al. (2004) Am J Respir Cell Mol Biol 31: 446-455; Alexander S P H, Benson H E, Faccenda E, Pawson A J, et al. 2013. “The concise guide to pharmacology 2013/14: G protein-coupled receptors”. British Journal of Pharmacology 170:1459-1581].

In an embodiment, the competitive P2Y₂ receptor antagonist has an half maximal inhibitory concentration (IC50) of below 100 μM, preferably below 35 μM, more preferably below 25 μM, even more preferably below 10 μM, even, even more preferably below 5 μM and most preferably below 1 μM. In one embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 35-100 μM. In a separate embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 25-35 μM. In another embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 10-25 μM. In another embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 5-10 μM. In a more preferred embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 1-5 μM. In a most preferred embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of less than 1 μM. Preferably, the competitive P2Y2 receptor antagonist has an IC50 between 0.1-1 μM.

In other embodiments, the agent is an oligonucleotide. In specific embodiments, the oligonucleotide is an antisense oligonucleotide, a ribozyme or an inhibitory RNA, including but not limited to a small inhibitory RNA (siRNA) or short hairpin RNA (shRNA).

In other embodiments, the agent is a gene knockout or gene editing system directed against P2Y2 receptor gene comprising Cas9 nuclease and guide RNA (gRNA) linked to a P2Y2 receptor sequence to target Cas9 nuclease to P2Y₂ gene so as to introduce a site-specific double-stranded break in the P2Y2 genomic DNA and produce a P2Y2 receptor knockout or edited gene. Cas9 nuclease and gRNA linked to a P2Y2 receptor sequence may be introduced directly into desired cells or alternatively by expression from expression plasmid or vector systems, including lentiviral system, adenoviral system or adeno-associated viral system. Design and use of such a gene knockout system (called CRISPR/Cas9 genome editing system) is known in the art (Mali P, Esvelt K M, and Church G M. 2013. “Cas9 as a versatile tool for engineering biology”. Nature Methods 10:957-963; Hsu P D, Lander E S, and Zhang F. 2015. “Development and Applications of CRISPR-Cas9 for Genome Engineering”. Cell 157(6); 1262-1278; as well as, see described references in the publications). Based on sequence for human P2Y2 receptor gene (NCBI Reference Sequence: NC_000011.10 for NCBI Gene ID 5029) and mRNA transcripts (NCBI Reference Sequence: NM_176072.2, NM 176071 and NM_002564), knockout or mutagenesis that reduces human P2Y2 receptor gene expression or activity may be obtained using publically available sequences and CRISPR/cas9 genome editing system to target specific region of the human P2Y2 receptor gene with appropriate gRNA linked to 20-nt or so sequence from the P2Y2 receptor gene. Commercial sources providing CRISPR/Cas9 genome editing system targeting the P2Y2 receptor gene include OriGene Technologies, Rockville, Md. (catalog number: KN204159), Santa Cruz Biotechnology, Santa Cruz, Calif. (catalog number: sc-401301, sc-401303-HDR, sc-401303-NIC, sc-401303-NIC-2, sc-401303-ACT, sc-401303-ACT-2, sc-401303-LAC and sc-401303-LAC-2). Using known P2Y2 receptor nucleic acid sequences available in public database such as public database housed at National Center for Biotechnology Institute (NCBI, Bethesda, Md.), P2Y2 receptor gene in other species may also be knocked-out, knocked-down, or mutagenized using the CRISPR/Cas9 genome editing system as well as other genetic tools known in the art, such as anti-sense oligonucleotide, ribozyme, siRNA, shRNA, and miRNA among others.

In other embodiments, provided herein are methods for increasing energy metabolism in a cell by contacting the cell with an agent that blunts the expression or activity of a P2Y₂ receptor, thereby increasing the metabolism in the cell. In specific embodiments, the cell is an adipocyte cell.

In specific embodiments, the agent is a fusion protein, polypeptide, a small non-nucleic acid organic molecule, a small inorganic molecule or an oligonucleotide, including but not limited to an antisense oligonucleotide, a ribozyme, or an inhibitory RNA, including but not limited to a small inhibitory RNA (siRNA) or a short hairpin RNA (shRNA).

Also provided herein are methods for increasing energy metabolism in an adipocyte cell in a subject that is at risk for or suffering from a disorder related to glucose metabolism, the method comprising administering to the subject an agent that inhibits expression or activity of a P2Y₂ receptor, thereby increasing the metabolism in the cell.

In various specific embodiments, the agent is a polypeptide, a small non-nucleic acid organic molecule, a small inorganic molecule, an antibody, an antisense oligonucleotide, a ribozyme or an inhibitory RNA, including but not limited to a small inhibitory RNA (siRNA) or a short hairpin RNA (shRNA).

Provided herein is also a method for identifying a candidate agent that modulates expression or activity of the P2Y₂ receptor, comprising: (a) providing a sample comprising the P2Y₂ polypeptide or a nucleic acid encoding the polypeptide; (b) contacting the sample with a test compound under conditions in which the polypeptide is active, the nucleic acid is expressed, or both; (c) evaluating expression or activity of the P2Y₂ polypeptide in the sample; and (d) comparing the expression or activity of the P2Y₂ polypeptide of (c) to the expression or activity of the P2Y₂ polypeptide in a control sample lacking the test compound, wherein a change in the P2Y₂ polypeptide expression or activity indicates that the test compound is a candidate agent that can modulate the expression or activity of the P2Y₂ polypeptide.

In various specific embodiments, the candidate agent selectively inhibits the P2Y₂ receptor or is a fusion protein.

Other features and advantages of the present invention will become more readily apparent to those of ordinary skill in the art after reviewing the following detailed description and accompanying drawings.

BRIEF DESCRIPTION OF THE FIGURES

The details of the present invention may be gleaned in part by study of the accompanying drawings, in which:

FIGS. 1A and 1B illustrate the changes in the body weights of P2Y2 knockout and wild-type mice fed regular diet or high-fat diet for 16 weeks. Specifically, the line graph shows the change in body weight of wild type (WT) and P2Y2 knockout (KO) mice fed regular diet (CNT) or high-fat diet (HFD) for 16 weeks with ad libitum access to food and drinking water. The * indicates data that is significantly different from the corresponding KO-HFD data point, as assessed by unpaired t test.

FIG. 2 is a photograph that shows the size of one of the highest weighing wild-type mouse with an average weighing P2Y2 knockout mouse from the high-fat diet groups. Specifically, the photograph provides a visual comparison of the size of one of the highest weighing wildtype mice from the high-fat diet group (WT-HFD) with an average weighing knockout mouse from the high-fat diet fed group (KO-FD).

FIG. 3A illustrates the food intake (g/day or g/g body weight) of the mice after 4 weeks of the Experimental Period. Specifically, the bar graph shows that food intake of WT and P2Y₂ KO mice on regular diet (CNT) or HFD determined after 4 weeks of start of the experimental period (expressed as g/day).

FIG. 3B illustrates the food intake (g/day or g/g body weight) of the mice after 12 weeks of the Experimental Period. Specifically, the bar graphs show that food intake of WT and P2Y₂ KO mice fed HFD for 12 weeks (expressed as g/day or g/g body weight).

FIG. 4A illustrates the water intake (ml/day or ml/g body weight) of the mice after 4 weeks of the Experimental Period. Specifically, the bar graph shows the water intake by WT and P2Y₂ KO mice fed regular diet (CNT) or HFD for 4 weeks with ad libitum access to food and drinking water.

FIG. 4B illustrates the water intake (ml/day or ml/g body weight) of the mice after 12 weeks of the Experimental Period. Specifically, the bar graphs show the water intake by WT and P2Y₂ KO mice fed HFD for 12 weeks.

FIG. 5A illustrates the urine output (ml/g body weight) and urine osmolality (mOsm/Kg) after 4 weeks of the Experimental Period. Specifically, the bar graphs show the urine output and urine osmolality in WT and P2Y₂ KO mice fed regular diet (CNT) or HFD for 4 weeks with ad libitum access to food and drinking water.

FIG. 5B illustrates the urine output (ml/g body weight) and urine osmolality (mOsm/Kg) after 12 weeks of the Experimental Period. Specifically, the bar graphs show the urine output and urine osmolality in WT and P2Y₂ KO mice fed HFD for 12 weeks with ad libitum access to food and drinking water.

FIG. 6A (a, b and c) are photographs that illustrate the appearance of abdominal fat in a (a) wild type mouse on a regular diet, (b) wild type mouse on a high-fat diet, and (c) P2Y2 knockout mouse on a high-fat diet, at the time of euthanasia. Specifically, the photographs show the appearance of abdominal fat at the time of euthanasia (terminal).

FIG. 6B are representative pictures of white fat from a high-fat diet wild type mouse (left) and knockout mouse (right). Specifically, the photographs show white fat obtained from HFD fed WT mouse (left panel) and KO mouse (right panel).

FIG. 6C are representative pictures of brown fat from a high-fat diet wild type mouse (left) and knockout mouse (right). Specifically, the photographs show brown fat obtained from HFD fed WT mouse (left panel) and KO mouse (right panel).

FIG. 7A illustrates the terminal weight of white adipose tissue (mg and mg/20 g body weight). Specifically, the graphs show the terminal weight of white adipose tissue in WT and P2Y₂ KO Mice fed regular diet (CNT) or HFD with ad libitum access to food and drinking water.

FIG. 7B illustrates the terminal weight of brown adipose tissue (mg and mg/20 g body weight). Specifically, the graphs show the terminal weight of brown adipose tissue in WT and P2Y₂ KO mice fed HFD with ad libitum access to food and drinking water.

FIG. 8 illustrates the terminal weight of the liver and kidney (mg/20 g body weight) in the mice after 16 weeks of the Experimental Period. Specifically, the graphs show the terminal weight of liver and kidney in WT and P2Y₂ KO mice fed regular diet (CNT) or HFD with ad libitum access to food and drinking water for 16 weeks.

FIG. 9 provides illustrative samples of the fecal matter in high-fat diet fed wild type mice (left) and knockout mice (right) during the 16 week Experimental Period. Specifically, the photograph shows the appearance of the fecal matter in high-fat diet fed wild type (WT-HFD) and knockout (KO-HFD) mice during the 16th week of feeding.

FIG. 10 provides the results of a Glucose Tolerance Test during the 14th week of the Experimental Period. Specifically, the graphs provide an evaluation of glucose tolerance in WT and P2Y₂ KO mice fed HFD with ad libitum access to food and drinking water. The GTT test was done during 14th week.

FIG. 11 provides the results of a Serum Insulin assay (left) and a Serum Leptin assay (right) after 16 weeks of the Experimental Period. Specifically, the graphs show serum insulin and leptin levels in WT and P2Y₂ KO mice fed a regular diet (CNT) or HFD with ad libitum access to food and drinking water for 16 weeks.

FIG. 12 provides the results of a Serum Adiponectin assay (left) and a Serum Free Fatty Acid assay (right) after 16 weeks of the Experimental Period. Specifically, the graphs show serum adiponectin and Free Fatty Acid (FFA) levels in WT and P2Y₂ KO mice fed a regular diet (CNT) or HFD with ad libitum access to food and drinking water for 16 weeks.

FIG. 13 provides the results of a Serum Triglycerides assay (left) and a Serum Glycerol assay (right) after 16 weeks of the Experimental Period. Specifically, the graphs show serum triglycerides (TG) and glycerol levels in WT and P2Y₂ KO mice fed a regular diet (CNT) or HFD with ad libitum access to food and drinking water for 16 weeks.

FIG. 14 provides Messenger RNA Expression level of PPAR in the Brown Fat (left) and the Messenger RNA Expression level of UCP in the Brown Fat (right). Specifically, the graphs show messenger RNA Expression of PPAR (left panel) and UCP (right panel) in the brown adipose tissue (Fat) of WT and P2Y₂ KO mice fed a regular diet (CNT).

FIG. 15 provides the Messenger RNA Expression level of Inflammatory Cytokines and Cell Surface Molecules (TNF-α, IL-6, MCP-1, CCR2, CD68, F4/80) in the White Fat (left) and the Messenger RNA Expression level of Insulin Receptor Substrate Isoforms (IRS 1, IRS 2) in the White Fat (right). Specifically, the graphs show messenger RNA expression of inflammatory cytokines and cell surface molecules (left panel) and insulin receptor substrate (IRS) isoforms in the white adipose tissue (Fat) of WT and P2Y₂ KO mice fed HFD for 16 weeks.

FIG. 16 provides mRNA expression of P2Y2 receptor in the organs involved in the development of obesity and diabetes mellitus. Data obtained by real-time RT-PCR on RNA extracted from different organs of wild type mice. Specifically, the graph shows mRNA expression of P2Y₂ receptor in the organs involved in the development of obesity and diabetes mellitus.

FIG. 17 provides mRNA expression of P2Y2 receptor in WHITE FAT of wild type mice after feeding high-fat diet feeding for 16 weeks. Specifically, the graph shows mRNA expression of P2Y₂ receptor in white fat of wild type mice after feeding high-fat diet feeding for 16 weeks.

FIG. 18 provides morphology of adipocytes in the WHITE FAT in wild type (WT) or P2Y2 receptor knockout (KO) mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks. Specifically, the photographs show the morphology of adipocytes in the white fat in WT or P2Y₂ receptor KO mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks.

FIG. 19 provides morphology of adipocytes in the BROWN FAT in wild type (WT) or P2Y2 receptor knockout (KO) mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks. Specifically, the photographs show the morphology of adipocytes in the brown fat in WT or P2Y₂ receptor KO mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks.

FIG. 20 provides whole body insulin sensitivity in wild type (WT) or P2Y2 receptor knockout (KO) mice after feeding control (CNT) or high-fat (HFD) diets. Specifically, the graph shows whole body insulin sensitivity in WT or P2Y₂ receptor KO mice after feeding control (CNT) or high-fat (HFD) diets.

FIG. 21 provides relative mRNA expression of insulin receptor (left panel) or glucose transporter type 4 (GLUT4) (right panel) in the white adipocytes of wild type (WT) or P2Y2 receptor knockout (KO) mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks. Specifically, the graphs show relative mRNA expression of insulin receptor (left panel) or glucose transporter type 4 (GLUT4) (right panel) in the white adipocytes of WT or P2Y₂ receptor KO mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

After reading this description it will become apparent to one skilled in the art how to implement the invention in various alternative embodiments and alternative applications. However, although various embodiments of the present invention will be described herein, it is understood that these embodiments are presented by way of example only, and not limitation. As such, this detailed description of various alternative embodiments should not be construed to limit the scope or breadth of the present invention as set forth in the appended claims.

P2Y2 receptor belongs to a family of purinergic G-protein coupled receptors numbering eight P2Y receptors in humans, which are stimulated by nucleotides, such as ATP, ADP, UTP, UDP and UDP-glucose. The eight P2Y receptors cloned in human are: P2Y1, P2Y2, P2Y4, P2Y6, P2Y1, P2Y12, P2Y13 and P2Y14 (see for a review of P2Y receptor family, including P2Y2 receptor, its agonist and antagonist ligands as well as molecular mechanisms and function by Abbracchio M P, Burnstock G, Boeynaems J-M, Barnard E A, Boyer J L, Kennedy C, Knight G E, Fumagalli M, Gachet C, Jacobson K A, and Weisman G A. 2006. “International Union of Pharmacology LVIII: Update on the P2Y G Protein-Coupled Nucleotide Receptors: From Molecular Mechanisms and Pathophysiology to Therapy”. Pharmacol. Rev. 58:281-341). Relatedness in the structures of the P2Y receptor family members result in similarities as well as differences in their affinity and activation by the different purine and pyrimidine nucleotides. P2Y2 receptor may be activated by UTP or ATP, both of which may also activate a related P2Y4 receptor in a species dependent manner. In addition to the P2Y receptor family members, other receptor families, such as P2X receptor family, may be stimulated by nucleotides, raising the issue of specificity and selectivity for any ligand, either agonist or antagonist, directed to a P2Y2 receptor.

As used herein, a P2Y2 receptor antagonist is defined as a ligand which upon binding to a P2Y2 receptor decreases the activity of the P2Y2 receptor, thereby decreasing P2Y2 receptor signaling.

A P2Y2 receptor antagonist is considered to be specific if the antagonist is bound only by P2Y2 receptor at the concentration used and decreases the activity of the P2Y2 receptor.

A P2Y2 receptor antagonist is considered to be selective if the antagonist is bound preferentially by P2Y2 receptor over a wide range of concentration, for example, 2-fold to 30-FOLD of the IC50 value of the compound, and decreases preferentially the activity of the P2Y2 receptor over other receptors.

A P2Y2 receptor antagonist is considered to be non-selective or slightly selective if the antagonist is bound by two or more members of the P2Y receptor family and/or P2X receptor family with no or little preferential binding by the P2Y2 receptor within a given concentration range and affects the activity of other members of the P2Y receptor family and/or P2X receptor family with no or little preferential effect on the P2Y2 receptor.

A P2Y2 receptor antagonist is said to compete non-competitively if the antagonist binds to the P2Y2 receptor to reduce its activity but does not prevent binding of UTP or ATP to the P2Y2 receptor.

A P2Y2 receptor antagonist is said to compete competitively if the antagonist binds to the same site as the site bound by UTP or ATP in the P2Y2 receptor.

As used herein, activity of P2Y2 receptor or P2Y2 receptor signaling may be used interchangeably and refers to increase in intracellular free Ca²⁺ or increased production of prostaglandin E2 or activation of protein kinase C.

In one embodiment, a P2Y2 receptor antagonist may be a pure antagonist in which the P2Y2 receptor antagonist inhibits P2Y2 receptor signaling independent of a cell type or tissue type either in vitro or in a subject. Inhibition of P2Y2 receptor activity occurs in all cells. In the absence of its native ligand, such as UTP or ATP, contacting with a pure P2Y2 receptor antagonist will not activate P2Y2 receptor signaling.

In one embodiment, a P2Y2 receptor antagonist may be a mixed P2Y2 receptor antagonist and agonist (antagonist/agonist), the mixed P2Y2 receptor antagonist/agonist may act as an antagonist in some tissues and an agonist in others. Such mixed P2Y2 receptor antagonist/agonist are contemplated within the invention so long as the mixed P2Y2 receptor antagonist/agonist antagonizes or inhibits P2Y2 receptor signaling in an organ or a tissue involved in the development of obesity and/or diabetes. Such an organ or a tissue comprises skeletal muscle, intestine, brown fat, white fat, liver, pancreas or kidney.

In one embodiment, a P2Y2 receptor antagonist or a mixed P2Y2 receptor antagonist/agonist inhibits P2Y2 receptor signaling in an organ or a tissue comprising skeletal muscle, intestine, brown fat, white fat, liver, pancreas, kidney, or other organ or tissue involved in obesity or diabetes. In one embodiment, obesity is diet-induced obesity. In one embodiment, diabetes is type II diabetes.

In one embodiment, a mixed P2Y2 receptor antagonist/agonist may activate P2Y2 receptor signaling in an organ or a tissue not involved in obesity or diabetes. One such organ or tissue not involved in obesity or diabetes may be lung in which P2Y2 receptor agonist may be beneficial to warding off lung infection and in the treatment of cystic fibrosis. In one embodiment, obesity is diet-induced obesity. In one embodiment, diabetes is type II diabetes.

In one embodiment, a P2Y2 receptor antagonist may be a mixed P2Y2 receptor antagonist/agonist that inhibits P2Y2 receptor signaling in an organ or tissue comprising skeletal muscle, intestine, brown fat, white fat, liver, pancreas, kidney, or other organ or tissue involved in obesity or diabetes, but not in a lung tissue.

In one embodiment, a P2Y2 receptor antagonist may be an antagonist in one species but may be an agonist in another species. For example, ATP is a potent competitive antagonist at the human P2Y4 receptor, but is a potent full agonist at the rat P2Y4 receptor (Herold C I, Qi A D, Harden T K, and Nicholas R A. 2004. “Agonist versus antagonist action of ATP at the P2Y4 receptor is determined by the second extracellular loop”. J Biol. Chem. 279(12):11456-64).

In addition to a role for P2Y2 receptor in obesity and diabetes, P2Y2 receptor in combination with its G protein effector, G_(q), G₀ or G₁₂, and signaling through these receptors in different cell types may bring about different biological and physiological responses as for example listed in Table 1 of Erb L and Weisman G A. 2012. “Coupling of P2Y receptors to G proteins and other signaling pathways”. WIREs Membr Transp Signal 1:789-803. The different biological and physiological responses include inhibition of bone formation and mineralization, immune cell recruitment and phagocytosis, vascular tone, inflammation, thrombosis, blood pressure regulation, intraocular pressure regulation, mechanical and thermal nociception, HIV infection of T cells, epithelial K+/Cl− secretion, pancreatic and renal functions, liver regeneration, and wound healing.

In one embodiment, a P2Y2 receptor antagonist may preferentially affect obesity and/or diabetes without affecting one or more selected from bone formation and mineralization, immune cell recruitment and phagocytosis, vascular tone, thrombosis, blood pressure regulation, intraocular pressure regulation, mechanical and thermal nociception, HIV infection of T cells, epithelial K⁺/Cl⁻ secretion, pancreatic and renal functions, liver regeneration, and wound healing. In one embodiment, obesity is diet-induced obesity. In one embodiment, diabetes is type II diabetes.

In one embodiment, a P2Y2 receptor antagonist may affect obesity and/or diabetes and affect one or more selected from bone formation and mineralization, immune cell recruitment and phagocytosis, vascular tone, thrombosis, blood pressure regulation, intraocular pressure regulation, mechanical and thermal nociception, HIV infection of T cells, epithelial K⁺/Cl⁻ secretion, pancreatic and renal functions, liver regeneration, and wound healing. In one embodiment, obesity is diet-induced obesity. In one embodiment, diabetes is type II diabetes.

In one embodiment, a mixed P2Y2 receptor antagonist may preferentially affect obesity and/or diabetes without affecting one or more selected from bone formation and mineralization, immune cell recruitment and phagocytosis, vascular tone, thrombosis, blood pressure regulation, intraocular pressure regulation, mechanical and thermal nociception, HIV infection of T cells, epithelial K⁺/Cl⁻ secretion, pancreatic and renal functions, liver regeneration, and wound healing. In one embodiment, obesity is diet-induced obesity. In one embodiment, diabetes is type II diabetes.

In one embodiment, a mixed P2Y2 receptor antagonist may affect obesity and/or diabetes and affect one or more selected from bone formation and mineralization, immune cell recruitment and phagocytosis, vascular tone, thrombosis, blood pressure regulation, intraocular pressure regulation, mechanical and thermal nociception, HIV infection of T cells, epithelial K⁺/Cl⁻ secretion, pancreatic and renal functions, liver regeneration, and wound healing. In one embodiment, obesity is diet-induced obesity. In one embodiment, diabetes is type II diabetes.

In one embodiment, a P2Y2 receptor antagonist may affect obesity or diabetes through inhibition of adipogenesis, increasing energy metabolism, promotion of lipolysis, stimulation of catabolism, maintaining insulin sensitivity and/or inflammation. In one embodiment, maintaining insulin sensitivity comprises prevention of insulin resistance and/or reversing insulin resistance. In one embodiment, obesity is diet-induced obesity. In one embodiment, diabetes is type II diabetes.

As used herein, insulin resistance is a condition in which cells in a subject or cells cultured in vitro do not respond to insulin effectively, resulting in lowered cellular uptake of glucose from the serum or cultured media. In vitro, insulin resistance may be induced by chronic exposure to insulin and/or glucose. A cell is said to have greater insulin sensitivity if the cell is better able to respond to insulin effectively than a less insulin sensitive or insulin resistant cell. Markers associated with glucose transport or metabolism as well as markers associated with insulin signaling may be used to assess insulin sensitivity or resistance of a cell, or alternatively, relative insulin sensitivity or resistance of a cell.

Provided herein are methods for selectively blocking the activity of the P2Y2 purinergic receptor for the prevention and/or treatment of diet-induced overweight or obesity. It was discovered that the genetic deletion of P2Y2 receptor results in resistance to the development of high-fat diet-induced obesity and the associated physical and molecular alterations in mice. The results described also suggest that the observed resistance of the P2Y2 receptor in knockout mice was not due to reduced consumption of high-fat diet or lack of absorption of fat in the intestines, but may be due to the ability of the knockout mice to metabolize or “burn” the extra calories consumed in the diet more efficiently than the wild type mice. Accordingly, targeting P2Y2 receptor with specific pharmacological agents or drugs is a safe approach to prevent or treat diet-induced overweight or obesity.

In various embodiments, provided herein are methods for treating or preventing diet-induced obesity in a subject by administering an agent that blunts the expression or activity of the P2Y₂ receptor in the subject.

In some specific embodiments, the agent is a fusion protein or an agent that inhibits the P2Y₂ receptor. In specific embodiments, the agent is a selective P2Y₂ receptor antagonist, including but not limited to a non-nucleic acid small organic molecule. In one embodiment, the P2Y₂ receptor antagonist is a non-competitive P2Y₂ receptor antagonist. The non-competitive P2Y₂ receptor antagonist may be a non-selective non-competitive P2Y₂ receptor which may inhibit other members of the P2Y receptor family [Ralevic V, Burnstock G. 1998. Receptors for purines and pyrimidines. Pharmacol Rev 50:413-492] with no selectivity for P2Y₂ receptor, a selective non-competitive P2Y₂ receptor antagonist with a selectivity for P2Y₂ receptor or a specific non-competitive P2Y₂ receptor antagonist inhibiting the activity of only P2Y₂ receptor. Preferably, the non-competitive P2Y₂ receptor antagonist is a selective non-competitive P2Y₂ receptor antagonist. More preferably, the non-competitive P2Y₂ receptor antagonist is a specific non-competitive P2Y₂ receptor antagonist. Non-competitive P2Y₂ receptor antagonist may be flavonoids. Useful flavonoids may be isolated from plant sources [Ververidis F, Trantas E. Douglas C, Vollmer G, Kretzschmar G, Panopoulos N (October 2007). “Biotechnology of flavonoids and other phenylpropanoid-derived natural products, Part I: Chemical diversity, impacts on plant biology and human health”. Biotechnology Journal 2 (10): 1214-34], such as Calycopteris floribunda Lamk. (Combretaceae) [Mayer R. 1999. Calycopterones and calyflorenones, novel biflavonoids from Calycopteris floribunda. J Nat Prod 62:1274-1278], Leptospermum scoparium Forst. (Myrtaceae) [Mayer R. 1990. Flavonoids from Leptospermum scoparium. Phytochemistry 29:1340-1342; Mayer R. 1993. A β-hydroxychalcone from Leptospermum scoparium. Planta Med 59:269-271], and tangerine peels from Citrus reticulate ssp., Rutaceae [Chen J, Montamari A M, Widmer W W. 1997. Two new polymethoxylated flavones, a class of compounds with potential anticancer activity, isolated from cold pressed dancy tangerine peel oil solids. J Agric Food Chem 45:364-368], microorganisms genetically engineered to produce flavonoids [Hwang E I, Kaneko M, Ohnishi Y, Horinouchi S (May 2003). “Production of plant-specific flavanones by Escherichia coli containing an artificial gene cluster”. Appl. Environ. Microbiol. 69 (5): 2699-706; Trantas E, Panopoulos N, Ververidis F (2009). “Metabolic engineering of the complete pathway leading to heterologous biosynthesis of various flavonoids and stilbenoids in Saccharomyces cerevisiae”. Metabolic Engineering 11 (6): 355-366; Ververidis F, Trantas E, Douglas C, Vollmer G, Kretzschmar G, Panopoulos N (2007). “Biotechnology of flavonoids and other phenylpropanoid-derived natural products. Part II: Reconstruction of multienzyme pathways in plants and microbes”. Biotechnology Journal 2 (10): 1235-49], and products of chemical or biochemical reactions leading to synthesis or modification of a flavonoid. In an embodiment, the non-competitive P2Y₂ receptor antagonist has an half maximal inhibitory concentration (IC50) of below 100 μM, preferably below 35 μM, more preferably below 25 μM, even more preferably below 10 μM, even, even more preferably below 5 μM and most preferably below 1 μM. In one embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 35-100 μM. In a separate embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 25-35 μM. In another embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 10-25 μM. In another embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 5-10 μM. In a more preferred embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of 1-5 μM. In a most preferred embodiment, the non-competitive P2Y₂ receptor antagonist has an IC50 of less than 1 μM. In yet another preferred embodiment, the non-competitive P2Y2 receptor antagonist has an IC50 between 0.1-1 M. Examples of non-competitive P2Y₂ receptor antagonist include strobopinin, strobopinin-7-methyl ether, 2′-β-Dihydroxy-4′,6′-dimethoxy-3′-methylchalcone (or Oxo-Aurentiacin), kaempferol, heptamethoxylflavone, and tangeretin with chemical structures and additional flavonoids described in Kaulich M, Streicher F, Mayer R, Muller 1, Muller C E. 2003. “Flavonoids—novel lead compounds for the development of P2Y₂ receptor antagonists”. Drug Development Research 59:72-81.

In one embodiment, the P2Y₂ receptor antagonist is a competitive P2Y₂ receptor antagonist. In one embodiment, the competitive P2Y₂ receptor antagonist may be a non-selective or slightly selective competitive P2Y₂ receptor antagonist. Examples of non-selective or slightly selective competitive P2Y₂ receptor antagonists include suramin (8,8′-[Carbonylbis[imino-3,1-phenylenecarbonylimino(4-methyl-3,1-phenylene)carbonylimino]]bis-1,3,5 naphthalenetrisulphonic acid) and Reactive Blue 2 (RB2) with an IC50 of between 5 μM and 35 μM [Kaulich M, Streicher F, Mayer R, Muller I, Muller C E. 2003. “Flavonoids—novel lead compounds for the development of P2Y₂ receptor antagonists”. Drug Development Research 59:72-81; Jacobson K A, Jayasekara, M P S, Costanzi S. 2012. “Molecular structure of P2Y receptors: mutagenesis, modeling, and chemical probes”. WIREs Membr Transp Signal 1:815-827; Jacobson K A. “P2X and P2Y receptors”. Tocris Bioscience Scientific Review Series, pp. 1-15]. In one embodiment, the competitive P2Y₂ receptor antagonist is a selective competitive P2Y₂ receptor antagonist. Examples of selective competitive P2Y₂ receptor antagonists include AR-C126313 and AR-C118925 comprising an IC50 of about 6 μM [Jacobson K A, Ivanov A A, de Castro S, Harden T K, Ko H. 2009. “Development of selective agonists and antagonists of P2Y receptors”. Purinergic Signalling 5:75-89; Meghani P. 2002. “The design of P2Y2 antagonists for the treatment of inflammatory diseases”. 224^(th) ACS National meeting, Abstracts, Division of medicinal chemistry 12; Kindon N, Meghani P, Thorn S (1998) World Pat. 98/54180; Kemp P A et al. (2004) Am J Respir Cell Mol Biol 31: 446-455; Alexander S P H, Benson H E, Faccenda E, Pawson A J, et al. 2013. “The concise guide to pharmacology 2013/14: G protein-coupled receptors”. British Journal of Pharmacology 170:1459-1581].

In an embodiment, the competitive P2Y₂ receptor antagonist has an half maximal inhibitory concentration (IC50) of below 100 μM, preferably below 35 μM, more preferably below 25 μM, even more preferably below 10 μM, even, even more preferably below 5 μM and most preferably below 1 μM. In one embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 35-100 μM. In a separate embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 25-35 μM. In another embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 10-25 μM. In another embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 5-10 μM. In a more preferred embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of 1-5 μM. In a most preferred embodiment, the competitive P2Y₂ receptor antagonist has an IC50 of less than 1 μM. Preferably, the competitive P2Y2 receptor antagonist has an IC50 between 0.1-1 μM.

In other embodiments, the agent is an oligonucleotide. In specific embodiments, the oligonucleotide is an antisense oligonucleotide, a ribozyme or an inhibitory RNA, including but not limited to a small inhibitory RNA (siRNA) or short hairpin RNA (shRNA).

In other embodiments, the agent is a gene knockout system directed against P2Y2 receptor gene comprising Cas9 nuclease and guide RNA (gRNA) linked to a P2Y2 receptor sequence to target Cas9 nuclease to P2Y2 gene so as to introduce a site-specific double-stranded break in the P2Y2 genomic DNA and produce a P2Y2 receptor knockout. Cas9 nuclease and gRNA linked to a P2Y2 receptor sequence may be introduced directly into desired cells or alternatively by expression from expression plasmid or vector systems, including lentiviral system, adenoviral system or adeno-associated viral system.

In other embodiments, provided herein are methods for increasing energy metabolism in a cell by contacting the cell with an agent that blunts the expression or activity of a P2Y₂ receptor, thereby increasing the metabolism in the cell. In specific embodiments, the cell is an adipocyte cell.

In specific embodiments, the agent is a fusion protein, polypeptide, a small non-nucleic acid organic molecule, a small inorganic molecule or an oligonucleotide, including but not limited to an antisense oligonucleotide, a ribozyme, or an inhibitory RNA, including but not limited to a small inhibitory RNA (siRNA) or a short hairpin RNA (shRNA).

Also provided herein are methods for increasing energy metabolism in an adipocyte cell in a subject that is at risk for or suffering from a disorder related to glucose metabolism, the method comprising administering to the subject an agent that inhibits expression or activity of a P2Y₂ receptor, thereby increasing the metabolism in the cell.

In various specific embodiments, the agent is a polypeptide, a small non-nucleic acid organic molecule, a small inorganic molecule, an antibody, an antisense oligonucleotide, a ribozyme or an inhibitory RNA, including but not limited to a small inhibitory RNA (siRNA) or a short hairpin RNA (shRNA).

Provided herein is also a method for identifying a candidate agent that modulates expression or activity of the P2Y₂ receptor, comprising: (a) providing a sample comprising the P2Y₂ polypeptide or a nucleic acid encoding the polypeptide; (b) contacting the sample with a test compound under conditions in which the polypeptide is active, the nucleic acid is expressed, or both; (c) evaluating expression or activity of P2Y₂ polypeptide in the sample; and (d) comparing the expression or activity of the P2Y₂ polypeptide of (c) to the expression or activity of the P2Y₂ polypeptide in a control sample lacking the test compound, wherein a change in the P2Y₂ polypeptide expression or activity indicates that the test compound is a candidate agent that can modulate the expression or activity of the P2Y₂ polypeptide.

In various specific embodiments, the candidate agent selectively inhibits the P2Y₂ receptor or is a fusion protein.

As shown herein, it was discovered that mice with genetic deletion of P2Y2 receptor consume the same amount of high-fat diet as their syngeneic wild type mice do, and do not excrete fatty stools (steatorrhea), yet do not become obese. This suggests that P2Y2 receptor is a potential target for the development of efficacious and safer anti-obesity drugs. One possible reason for this phenomenon is that purinergic P2Y2 receptor is involved in energy metabolism and so its genetic deletion significantly protects against high-fat diet-induced obesity. Accordingly, purinergic antagonism may prove to be a very advantageous invention over the current state-of-the-art.

This is further supported by the fact that one promising line of future anti-obesity drugs is based on the development of ribonucleic acid interference (RNAi) to silence RIP140 gene, a nuclear co-repressor that regulates fat accumulation. This line of drug development was prompted by the observation that mice with genetic deletion of RIP140 exhibit a lean profile throughout their life, and are resistant to diet-induced obesity, and show an enhanced metabolic rate. CytRx Corporation is currently developing RNAi therapeutics against this drug target (RIP140) for the treatment of obesity and type 2 diabetes. Conversely, disruption of the molecular interaction between SMRT, a nuclear hormone receptor co-repressor and its receptor partner leads to increased adiposity and decreased metabolic rate.

The novel findings described herein open the possibility to develop an entirely new line of drugs that target the molecular interactions between C protein-coupled receptors and their downstream regulatory effectors to prevent or treat diet-induced obesity. Through the availability of gene knockout mice that carried these molecular disruptions in vive throughout their lifespan, researchers are able to assess the efficacy and safety of this promising approach in live mice.

As discussed in detail herein, it was discovered that genetic deletion of P2Y2 receptor causes resistance to diet-induced obesity. The data indicates that this effect is likely related to increased metabolic rate and the effect is associated with better glucose tolerance as well as a sign of better balance between energy intake and expenditure.

The invention described herein has potential practical and commercial applications to develop a new line of anti-obesity drugs that are safe and efficacious. This can be achieved by either designing and developing P2Y2 receptor selective antagonists (chemical molecules) or RNAi to silence the P2Y2 receptor gene.

EXAMPLES Example 1: Mice that are Genetically Deficient in P2Y2 Receptor

A bench prototype was generated in mice that are genetically deficient in P2Y2 receptor. These mutant mice apparently do not suffer from diseases, have no pathological lesions and live healthy. Although one study showed that these mice develop salt-resistant hypertension, the rise in blood pressure was modest, and these mice do not develop complications of hypertension, such as kidney disease. See, Rieg et al., 2007, FASEB J 21:3717-3726.

Hence, targeting purinergic signaling for the treatment of obesity is relatively safe as compared to the current state-of-the-art. Any potential increase in blood pressure can be effectively controlled with combination therapy.

Example 2: Wild Type and P2Y2 Receptor Knockout Study

A study was performed on wild type and P2Y₂ receptor knockout mice (both in B6D2 genetic background). Breeders of these mice were originally obtained from Dr. Beverly Koller of the University of North Carolina at Chapel Hill, Chapel Hill, N.C.

Obesity is associated with deranged sodium homeostasis leading to hypertension among other pathologies. Hence, this high-fat diet study was conceived to examine the role of P2Y2 receptor in obesity-induced alterations in water and sodium handling by the kidney, leading to hypertension. Since kidney is one of the vital organs affected by obesity, it was posited that any new information obtained may help to address more complex questions, such as the course of lithium-induced nephrogenic diabetes insipidus in obese patients and the effect of lack of purinergic signaling. However, during the study it was observed that P2Y2 receptor knockout mice were resistant to the diet-induced obesity, which forms the basis for this invention.

Experimental Study Parameters

Breeding colonies were established in the Veterinary Medical Unit (VMU) of the VA Salt Lake City Health Care System. Mice bred were identified by Polymerase Chain Reaction (“PCR”) on DNA extracted from the tail clippings, and all mice were tracked by implanting microchip transponders under the skin. Age matched adult wild type and P2Y2 receptor knockout (KO) mice were randomly divided into two sub-groups for each genotype and were fed regular rodent chow (10% of total energy as fat) or high-fat diet (60% or total energy as fat) for 16 weeks as shown below. The high-fat diet was purchased from the Research Diets, Inc. (New Brunswick, N.J.).

Wild Type Mice P2Y₂ Receptor Knockout Mice Regular Diet High-Fat Diet Regular Diet High-Fat Diet N = 6 N = 14 N = 6 N = 14

All mice had free access to drinking water throughout the experimental period. Food intake and body weights were monitored on regular basis. Twenty-four hour urine samples were collected periodically by placing the mice in metabolic cages with free access to food and drinking water. Feces samples of all groups of mice were collected periodically. During the 14^(th) week, tolerance of the mice to an acute load of glucose was assessed by carrying out glucose tolerance test (“GTT”). All mice were euthanized at the end of the experimental period and samples of blood, liver, kidney, pancreas, spleen and whole white and brown adipose tissues were collected for analysis in the laboratory.

The GTT tests were performed as described by Takahashi et al (2011). Briefly, after a fasting period of about 12 hours, the mice received an intraperitoneal injection of sterile glucose solution (1.5 g/kg body wt.). Tiny droplets of blood (˜5 μl) were obtained in conscious mice by gently pricking the dorsal pedal vein with a fine needle. Using these droplets, blood glucose levels were determined with a clinical glucometer. Blood samples were collected prior to (0 min), and 30, 60, 90 and 120 min after intraperitoneal injection of glucose solution.

Twenty-four hour urine output was recorded, and the osmolalities of clear urine samples were determined by vapor pressure method on an osmometer (Wescor, Logan, Utah). Insulin, leptin, adiponectin, triglycerides and glycerol levels in the serum samples were determined by using commercial ELISA or EIA kits (Crystal Chern, Inc., Downers Grove, Ill. or Cayman Chemical Co., Ann Arbor, Mich.). Weights of total brown or white adipose tissues were determined for each mouse. Total liver and kidney weights were also determined.

Liver tissue samples were analyzed for metabolic change in the University of Utah Metabolomic Core Facility using gas chromatography-mass spectrometry (GC-MS). For this analysis, about 20 mg of liver tissue from each mouse (N=6 mice/group) was used. The liver tissue was flash frozen in liquid nitrogen at the time of euthanasia and then stored at −80° C. In the core facility, the tissue was mechanically disrupted using a bead mill, and metabolites were extracted by a solvent. After evaporating the solvent, the dried samples were suspended in O-methoxylamine hydrochloride (MOX) and further processed for GC-MS. GC-MS data was collected using MassLynx 4.1 software (Waters).

A two-step process was employed for data analysis, a targeted followed by non-targeted analysis. For the targeted approach, known metabolites were identified and their peak areas were recorded using QuanLynx. For the non-targeted approach peak picking and analysis was performed using MarkerLynx. Principle components analysis (PCA) and partial least squares-discriminate analysis (PLS-DA) was performed using SIMCA-P 12.0 (Umetrics, Kinnelon, N.J.). Metabolite identity was established using a combination of an in-house metabolite library developed using pure standards and the commercially available NIST library. Not all metabolites were observed using GC-MS.

Quantitative data are presented as mean±sem. Comparisons among the means of multiple groups were made by one-way analysis of variance (ANOVA), followed by the assessment of statistical significance by Tukey-Kramer Multiple Comparison test or Boneferroni test for selected pairs. Differences between the means of two groups were determined by unpaired t-test or Mann-Whitney nonparametric method. P values less than 0.05 were considered significant. GraphPad Instat® software (GraphPad Software, Inc., La Jolla, Calif.) was used for statistical analysis.

Study Results

FIG. 1 illustrates the changes in the body weights in (WT) and P2Y2 knockout (KO) mice fed regular diet or high-fat diet for 16 weeks. As shown in FIG. 1A, the WT mice had modestly, but significantly higher body weights even on day 0 as compared to the age-matched KO mice. Following high-fat diet (HFD) feeding, the body weight or WT mice steadily increased starting at 2 weeks. In contrast, body weights of high-fat diet fed KO mice essentially remained similar to the regular diet (CNT)-fed KO mice throughout the study period. FIG. 1B and FIG. 1C show the terminal (16 weeks) body weights of the high-fat diet fed WT vs. high-fat diet fed KO mice. The differences between these two groups are striking when analyzed as weights of individual mice using scattergraph (FIG. 1B, left) or as box plots (FIG. 1B, right).

FIG. 2 shows a picture of mice to compare the size of one of the highest weighing WT mice from the high-fat diet group (WT-HFD) with an average weighing KO mouse from the high-fat diet group (KO-HFD). In order to exclude the possibility that the differences observed in body weights of the WT and KO mice was due to differences in their food and/or water intake, the food and water intake of the mice at two different time points was determined (see below).

FIG. 3A shows food intake as g/day/mouse after 4 weeks. As shown in this figure, the high-fat diet fed WT mice consumed significantly less amount of food as compared to the regular diet fed WT mice. However, there was no difference in the food intake between the WT or KO mice when high-fat diet was fed to them.

FIG. 3B shows food intake in high-fat diet fed WT or KO mice after 12 weeks. The left panel presents the data as g/day/mouse, whereas the right panel shows the data as g/g body weight per day. Notably, at this time point the KO mice were consuming significantly higher amount of food, despite the fact that their body weights were significantly lower as compared to the body weights of the high-fat diet fed WT mice (see, FIG. 1). Thus, the observed lack of gain in the body weight in high-fat diet fed KO mice was not due to consumption of lesser amount of food. In fact, food consumption in these mice is relatively higher when normalized to the body weight.

FIG. 4A shows water intake as ml/day/mouse after 4 weeks. Although there were no significant differences between the genotypes, high-fat diet significantly reduced water intake in both genotypes. FIG. 4B shows water intake in high-fat diet fed W and KO mice after 12 weeks. The left panel presents data as ml/day/mouse, whereas the right panel shows data as ml/g body weight per day. Similar to the food consumption, the KO mice were drinking significantly higher amount of water relative to their body weight, despite the fact that their body weights were significantly low as compared to the body weights of the high-fat diet fed WT mice (see, FIG. 1).

FIG. 5A shows urine output and urine osmolality after 4 weeks in WT and KO mice fed regular or high-fat diets. As shown in the left panel, high-fat diet caused significant decrease in urine output in both genotypes. However, high-fat diet did not have any effect on the urine osmolality in WT or KO mice. FIG. 5B shows urine output and urine osmolality in high-fat diet fed WT and KO mice after 12 weeks. Interestingly at this time point the urine output when expressed as ml/g body wt/day was modest, but significantly higher in the KO mice (left panel). However, no differences were noted in urine osmolality between these two groups after 12 weeks.

FIG. 6A shows representative pictures of the appearance of abdominal fat at the time of euthanasia. Panel 6Aa shows the appearance of normal content and disposition of abdominal fat in a WT mouse fed regular diet, which is similar to KO mice fed a regular diet (not shown here). In contrast, high-fat diet fed WT mice have much higher amounts of abdominal fat (FIG. 6Ab) as compared to the high-fat diet fed KO mice (FIG. 6Ac).

In mammals, fat or adipose tissue exists in two distinctive forms—the white and brown adipose tissues. White adipose tissue is a storage form of energy and accumulates excessive calories consumed as fat droplets, usually found around the abdominal wall or the belly. White adipose tissue burns slowly, and is linked to the risk for diabetes and heart diseases. Conversely, the brown fat, which is rich in mitochondria and capillaries (hence the color), burns calories to generate heat. Brown fat is abundant in newborns and hibernating mammals, whereas the white fat is abundant in adults. FIG. 6B and FIG. 6C are representative pictures of white or brown fat obtained from the high-fat diet fed WT or KO mice. The difference in the masses of these two types of tissues between the genotypes was quite obvious.

FIG. 7A shows the terminal weights of white adipose tissue in the WT and KO mice fed regular or high-fat diet. As shown, the WT mice fed high-fat diet had a 2 to 3-fold higher amount of white fat as compared to the regular diet fed WT mice, depending on whether the fat content was expressed as mg/mouse or mg/20 g body weight. On the other hand, the high-fat diet feeding had no significant effect on the white adipose tissue in the KO mice. FIG. 7B shows the terminal weights of brown adipose tissue in WT and KO mice fed high-fat diet. Similar to the white adipose tissue, high-fat diet feeding had a significant effect on brown adipose tissue only in the WT mice.

Since the liver and kidney are two vital organs affected by obesity, their weights were recorded as a function of body weight at the time of euthanasia. As shown in FIG. 8, in high-fat diet fed WT mice the weights of both liver and the kidney were significantly low when adjusted for the body weight. In contrast, a high-fat diet did not have any effect on the weights of the liver and kidney in KO mice.

If the apparent resistance of the KO mice to high-fat diet induced increase in body weight and accumulation of body fat is due to defective absorption of fat in the intestines, then one would expect steatorrhea in these mice. Steatorrhea is a condition where the feces contain partially digested fat as oil. The feces are not well formed, and have an oily appearance and foul smell. Hence, the fecal matter in the high-fat diet fed WT and KO mice was monitored. FIG. 9 shows representative profiles of the fecal matter in high-fat diet fed wild type (WT-HFD) and knockout (KO-HFD) mice collected during the last week of experimental period (16 weeks). As illustrated in this figure, both WT and KO mice fed high-fat diet have well-formed, and non-oily fecal matter. These observations rule out the possibility of lack of absorption of fat in the intestines in KO mice.

Glucose tolerance or the ability to metabolize a load of glucose is impaired in obese subjects, And obesity is a known risk factor for the development of type II diabetes, where the subjects develop resistance to insulin and thus cannot metabolize glucose efficiently, despite high blood insulin levels. To examine whether the high-fat diet induced increase in body weight in the wild type mice is associated with glucose intolerance, a Glucose Tolerance Test (GTT) using a standard protocol was performed.

FIG. 10 shows the results of the GTT in different groups of mice. As shown in the left panel of FIG. 10, at 30 min after an acute load of glucose, the high-fat diet fed WT mice showed the highest blood level of glucose, about 400 mg/dl. The corresponding blood glucose level in high-fat diet fed KO mice was significantly low. In fact at all the time points following an acute glucose load, the high-fat diet fed KO mice had significantly lower blood glucose levels as compared to the high-fat diet fed WT mice (FIG. 10, right panel).

Notably, the baseline (0 min) blood glucose levels in the WT mice were modest, but significantly elevated as compared to the KO mice (FIG. 10, right panel). Furthermore, at 30 min time point following an acute load of glucose, the differences among the four groups were very obvious, with the two WT groups having higher blood glucose levels as compared to the two KO groups. Similar to the high-fat diet fed WT and KO mice, the differences in blood glucose levels between the regular diet fed WT and KO mice were also wide apart at 30 min time point, indicating that KO mice are inherently efficient in metabolizing a load of glucose faster.

Insulin, released from the beta-cells of islets of Langerhans in the pancreas in response to increasing blood glucose levels (e.g., following a meal), is the key hormone in regulating the blood glucose levels by inducing uptake of glucose by cells and its subsequent metabolism. In type II diabetes, the cells develop resistance to the action of insulin with the result the subjects have both high blood glucose and high blood insulin levels. The left panel of FIG. 11 shows terminal serum insulin levels in the blood samples collected at the time of euthanasia. As illustrated in this figure, following high-fat diet feeding for 16 weeks, the WT mice had more than 2-fold increase in serum insulin. The insulin levels in the KO mice were not affected by high-fat diet feeding. These results correlate well with the pattern of GTT results obtained.

Leptin is a peptide hormone elaborated mainly by white adipose tissue, although brown adipose tissue and other organs also produce leptin. The levels of circulating leptin are proportional to the total amount of the fat in the body. In general, leptin is considered to play a key role in regulating energy intake and energy expenditure, including appetite and metabolism. Leptin acts on the hypothalamus and inhibits appetite. Hence, the absence of leptin leads to uncontrolled food intake resulting in obesity, e.g., ob/ob mutant mice that lack leptin.

When these mutant mice are treated with leptin injections, they lose excess body fat and return to normal body weight. However, despite these properties of leptin, obese subjects often develop resistance to leptin so their appetite is not reduced by high circulating leptin levels. This is because of leptin desensitization due to high circulating leptin levels in obese subjects. In view of this, serum levels of leptin in the mice were determined. As shown in the right panel of FIG. 11, high-fat diet feeding for 16 weeks caused more than a 3-fold increase in the serum leptin levels in WT mice. The increase in serum leptin levels in high-fat diet fed KO mice was modest.

Adiponectin is a protein hormone produced exclusively from adipose tissue (and also from placenta during pregnancy). Adiponectin modulates a number of metabolic functions, such as glucose metabolism and fatty acid catabolism. Adiponectin also plays roles in the suppression of metabolic derangements, such as those occurring due to type II diabetes mellitus, obesity, atherosclerosis, as well as others. In general, adiponectin is considered as an independent risk factor for metabolic syndrome. Similar to leptin, the weight reducing effects of adiponectin are mediated via brain. In view of this, the serum adiponectin levels in the blood samples collected was determined at the time of euthanasia, i.e., after 16 weeks of feeding the respective diets.

As shown in FIG. 12 left panel, the serum adiponectin levels are modestly, but significantly elevated in high-fat diet fed WT mice, but not in KO mice. The increase in serum adiponectin in the WT mice may be due to higher fat content in the body, and also in response to the increase in the body weight. However, similar to higher serum leptin levels in these mice, the higher adiponectin levels did not counter the high-fat diet-induced increase in body weight in WT mice. Since adiponectin is involved in fatty acid catabolism, the serum free fatty acids (FFA; FIG. 12, right panel), serum triglycerides (TG; FIG. 13, left panel) and serum glycerol (FIG. 13, right panel) were determined. As shown, the serum FFA levels were not significantly different among the four groups of mice, although high-fat diet had a tendency for higher levels of serum FFA in both genotypes. Interestingly, serum TG levels were significantly higher in KO mice as compared to the WT mice, irrespective of the dietary regimen, and dietary regimen itself did not have any effect in either genotype. In contrast, a high-fat diet triggered significantly higher (about 2-fold) serum glycerol levels in both genotypes.

Further insights into the metabolic profiles of the WT and KO mice and the effect of high-fat diet feeding, were obtained by performing a metabolomics analysis of the liver tissue. Table 1 below provides the data obtained for 23 carbohydrate metabolites, 20 protein metabolites, 22 lipid metabolites and 5 nucleic acid metabolites.

TABLE 1 Metabolomic Analysis of Liver Tissue by GC-MS GC-MS data presented here are in arbitrary units and expressed as mean ± sem Metabolites shown with an asterisk on the right end of the line have interesting or significant trends with respect to genotype or dietary regimen or both. WT-CNT WT-HFD KO-CNT KO-HFD Carbohydrate Metabolites Lactic Acid 687 ± 89 556 ± 59 559 ± 59 585 ± 64 Pyruvic Acid 159 ± 34 129 ± 9  110 ± 9  118 ± 6  Glycerol  1.26 ± 1.00  0.69 ± 0.06  3.82 ± 0.24   2.85 ± 0.78 * Glyceric Acid 558 ± 44 763 ± 79 475 ± 32  941 ± 49 * Citric Acid 35.3 ± 3.1 34.2 ± 4.4 34.4 ± 3.8 37.0 ± 5.9 Aconitic Acid  7.08 ± 1.38  3.08 ± 0.74  3.12 ± 0.21  2.85 ± 0.43 Isocitric Acid  6.03 ± 1.25  9.65 ± 3.94  5.06 ± 0.21  5.58 ± 0.67 2-Ketoglutaric Acid  1.99 ± 0.57  1.97 ± 0.31  1.08 ± 0.37  1.61 ± 0.24 Succinic Acid 2463 ± 291 2657 ± 293 2402 ± 332 3130 ± 340 Fumaric Acid 355 ± 14 327 ± 45 279 ± 50 330 ± 36 Malic Acid 709 ± 49  753 ± 110 558 ± 73  819 ± 100 2-Hydroxyglutarate  4.06 ± 0.34  4.29 ± 0.48  1.72 ± 0.44  3.09 ± 0.39 2-Aminoadipic Acid  5.70 ± 1.02  9.11 ± 1.54  7.84 ± 1.85  14.72 ± 4.25 * Glucose 21885 ± 853  22570 ± 1575 20706 ± 587  20302 ± 253  Fructose 466 ± 62 536 ± 60 442 ± 47 535 ± 45 Ribose  0.287 ± 0.019  0.395 ± 0.079  0.222 ± 0.011   0.321 ± 0.094 * Galactose or isomer 2605 ± 283 1942 ± 112 1994 ± 166  1571 ± 49 * Glucose-1-Phosphate 204 ± 22 194 ± 18 338 ± 27  214 ± 25 * Glucose-6-Phosphate 1009 ± 106 1025 ± 161 1922 ± 142  1285 ± 149 * Sorbitol 19.9 ± 3.6 12.5 ± 1.1 22.2 ± 4.0   6.5 ± 1.0 * Galacitol 289 ± 55 337 ± 15 245 ± 40 348 ± 52 Disaccharide  5126 ± 1454 5581 ± 743 3866 ± 859  1474 ± 314 * Xylulose-5-monophosphate 24.3 ± 1.9 20.1 ± 3.5 22.5 ± 1.5 23.2 ± 1.6 Protein Metabolites Lysine  40.3 ± 16.3  41.2 ± 13.2  54.9 ± 31.6 50.0 ± 8.6 Valine 417 ± 61 422 ± 41 412 ± 92 414 ± 28 Leucine 1798 ± 301 1749 ± 154 1659 ± 401 1761 ± 134 Isoleucine 1047 ± 152 1049 ± 92  1002 ± 247  997 ± 123 Threonine 166 ± 29 167 ± 11 141 ± 25  211 ± 14 * Glycine 582 ± 60 217 ± 33 486 ± 74  171 ± 18 * Serine 51 ± 9 34 ± 4 39 ± 5 36 ± 5 Alanine 1037 ± 94   826 ± 128  989 ± 179 1230 ± 100 Glutamic Acid 104 ± 18 123 ± 12  92 ± 14  187 ± 32 * Glutamine 2891 ± 208 2470 ± 318 1835 ± 258  2783 ± 86 * Proline  683 ± 116  776 ± 104  728 ± 174  1835 ± 261 * Aspartic Acid 24.7 ± 3.3 29.0 ± 3.6 25.0 ± 3.7 36.1 ± 2.6 Aspargine  6.0 ± 1.1  8.4 ± 3.4  3.7 ± 1.2  8.8 ± 1.8 Methionine  81.0 ± 16.5 65.9 ± 8.2 53.5 ± 6.2 75.2 ± 7.1 Cysteine 18.6 ± 6.1  27.0 ± 15.1 28.1 ± 9.7  26.7 ± 10.0 Phenylalanine 296 ± 60 283 ± 30 271 ± 36 279 ± 18 Tyrosine 14.7 ± 5.8 14.3 ± 4.0 12.9 ± 3.4 17.1 ± 3.2 Tryptophan  33.2 ± 15.4  33.2 ± 12.6 24.4 ± 8.4 16.2 ± 6.1 Histidine  1.99 ± 0.76  2.32 ± 0.96 2.95 ± 1.1  1.5 ± 0.3 Ornithine 11.7 ± 2.7 10.0 ± 2.0 10.7 ± 2.1 11.4 ± 2.0 Lipid Metabolites Phosphate 14724 ± 801  15003 ± 1007 13232 ± 640  13590 ± 270  Diphosphate 1968 ± 402  5183 ± 2133 1636 ± 161  2930 ± 608 * Phosphoglycerol 11517 ± 299  10969 ± 790  9647 ± 334 11729 ± 395  3-Phosphoglycerate 471 ± 84 438 ± 87 205 ± 27  204 ± 24 * 2-Phosphoglycerate 27.4 ± 4.3 23.4 ± 2.9 15.0 ± 1.5  13.0 ± 1.3 * DHAP  7.47 ± 1.05  6.78 ± 0.46  5.53 ± 0.53  5.87 ± 0.60 Inositol 2964 ± 266 2030 ± 119 2283 ± 175 1940 ± 165 Myo-inositol Phosphate 345 ± 70  465 ± 109 258 ± 13  363 ± 74 * Lauric Acid 37.5 ± 3.0 37.2 ± 3.6 32.6 ± 1.5 35.4 ± 2.0 Myristic Acid  87.8 ± 10.3 73.5 ± 5.5 87.1 ± 8.7  63.0 ± 5.5 * Palmitaladic Acid  73.3 ± 17.0 40.4 ± 6.9  89.3 ± 23.5  24.4 ± 5.7 * Palmitic Acid  6714 ± 1091  7911 ± 1181 6285 ± 967  7838 ± 1014 Linoelic Acid  667 ± 143  759 ± 159  560 ± 145  572 ± 106 Oleic Acid  670 ± 138  851 ± 141  635 ± 171  662 ± 117 Elaidic Acid 120 ± 25 126 ± 28 175 ± 33   87 ± 18 * Stearic Acid 2662 ± 462 4471 ± 682 2206 ± 344  3892 ± 559 * Arachidonic Acid  56.0 ± 10.6  62.5 ± 15.4 46.4 ± 2.1 54.8 ± 6.8 1-Monooleoylglycerol 368 ± 85  498 ± 113  377 ± 129 475 ± 53 1-monostearylglycerol 1727 ± 367 2879 ± 502 1428 ± 337  2696 ± 289 * 1-Monopalmitoylglycerol 3808 ± 741 4606 ± 880 3645 ± 736 5011 ± 609 1-Monopalmitoylylglycerol 26.1 ± 6.0 23.6 ± 6.7  36.3 ± 10.8  16.5 ± 2.6 * Cholesterol 1316 ± 113 1416 ± 163 1146 ± 126 1367 ± 109 Nucleic Acid Metabolites Xanthine 1133 ± 129 1183 ± 167 972 ± 83  940 ± 150 Adenosine  1.87 ± 0.33  1.82 ± 0.31  2.45 ± 0.26  2.16 ± 0.24 Inosine 394 ± 50 295 ± 50 276 ± 30  217 ± 52 * Adenine 146 ± 13 153 ± 12 127 ± 4   167 ± 17 * Uracil  42.7 ± 11.9 54.3 ± 9.0 21.6 ± 2.8 292.8 ± 98 

Significant differences and interesting trends have been noted in several of these metabolites as shown with respect to genotype (WT vs. KO) or the diet (regular diet vs. high-fat diet) or both variables.

Based on the data disclosed herein, it appears that the KO mice are resistant to high-fat diet-induced obesity. There are three possible explanations for this. The first possibility is a decreased appetite leading to less consumption of food. A second possibility is a lack of absorption of fat in the digestive system. Finally, the third possibility is increased ability to burn more calories due to higher energy metabolism.

In the studies presented, the first two possibilities were eliminated, i.e, the KO mice were not eating less food than the WT mice, and the KO mice had well-formed stools with no evidence of steatorrhea. This leaves the third possibility, i.e., increased ability to burn more calories or higher energy metabolism. To confirm this, the expression of key genes in the WT and KO mice under basal or normal conditions, i.e., without feeding high-fat diet, were examined.

FIG. 14 shows the expression of two groups of key molecules involved in energy metabolism in the brown fat, which is rich in mitochondria. These are the PPARs (peroxisome proliferator-activated receptor), the nuclear receptors, involved in the regulation of inflammation and energy homeostasis and thus represent important targets for obesity and metabolic syndrome.

PPAR-α knockout mice are known to gain more adipose tissue mass as compared to the wild type mice. PPAR-γ plays a role in adipocyte differentiation, and reduces inflammatory gene expression. Less is known about the role of PPAR-δ in obesity, but it stimulates fatty acid oxidation.

As shown in the left panel of FIG. 14, PPAR-γ and PPAR-δ expression levels in KO mice are significantly higher as compared to the WT mice, while the expression of PPAR-α did not differ. Thus, the observed resistance of the KO mice to diet-induced obesity is partly related to the differences in baseline expression of the PPAR isoforms in these mice as compared to the WT mice.

Another potential group of molecules considered were the mitochondrial uncoupling proteins (UCPs). UCPs are themogenic proteins and regulate energy expenditure. They uncouple mitochondrial respiration for oxidative phosphorylation (formation of ATP), resulting in dissipation of energy as heat, instead of converting into storage form of energy. UCPs play a role in the development of obesity and type II diabetes mellitus. As shown in the right panel of FIG. 14, the basal expression levels of all three UCPs in the brown fat of KO mice are significantly higher as compared to the expression levels in WT mice. This advocates for the conclusion that KO mice are inherently capable of burning extra calories consumed in the food.

The enlarged fat cells in the white adipose tissue in obesity recruit macrophages (inflammatory cells) and promote inflammation, leading to elaboration of various cytokines (inflammatory molecules) and chemical mediators. Accordingly, the inflammatory mediators in the white fat of the WT and KO mice were examined after feeding high-fat diet for 16 weeks. As shown in the left panel of FIG. 15, the expression levels of IL-6 (interleukin-6, an inflammatory cytokine), MCP-1 (monocyte chemoattractant protein-1 or CCL2) and its receptor (CRR2), CD68 (monocyte/macrophage cluster differentiation 68 protein), as well as F4/80 (a defining marker of murine macrophages) were significantly lower in the KO mice as compared to the WT mice. This suggests a lesser degree of inflammation in the white adipose tissue of KO mice versus WT mice after feeding high-fat diet.

During the study, the expression of insulin receptor substrate (IRS) 1 and 2 was examined. These receptors transmit signals from the insulin receptor and insulin-like growth factor-1 (IGF-1), and thus play an important role in metabolic pathways. Mice lacking IRS1 develop a mild diabetic phenotype, whereas the mice lacking IRS2 have a diabetic phenotype. As shown in the right panel of FIG. 15, the IRS1 expression was markedly higher in the KO mice fed high-fat diet versus WT mice fed high-fat diet, whereas the expression levels of IRS2 did not differ between these two genotypes. This finding suggests that IRS1 contributes to the observed resistance of the KO mice to diet-induced obesity.

Example 3: Disruption of P2Y₂ Receptor Gene is Protective Against Diet-Induced Obesity and Insulin Resistance

Development of insulin resistance (IR) in obesity is attributed to inflammation and lipotoxicity in white adipose tissue (WAT), among other factors. We observed that genetic deletion of P2Y 2-R confers significant resistance to development of high-fat diet (HFD)-induced obesity and improves glucose tolerance. P2Y2-R is expressed in all the key organs involved or potentially contributing to JR (white fat (epididymal, EP), white fat (subcutaneous, SC), brown fat, liver, skeletal muscle, kidney, intestines, and pancreas; FIG. 16). We investigated whether P2Y2-R may facilitate diet-induced IR, insulin signaling and inflammation in WAT of wild type (WT) and P2Y2-R knockout (KO) mice fed HFD.

Groups of age-matched adult WT and KO mice were fed regular diet (10% calories as fat; n=6) or HFD (60% calories as fat; n=14) with free access to food and water for 16 weeks and euthanized. An insulin sensitivity test (IST) was conducted.

Briefly for insulin sensitivity test, mice were fasted for 4 hours with tree access to drinking water. Baseline (0 min) blood samples (3 to 5 μl) were collected by gently pricking the foot, and blood glucose was determined by the use of Ascensia Contour Blood Glucose Meter (Bayer HealthCare). The mice were then intraperitoneally injected with human insulin (Humalin® R-100, Eli Lilly) at a dose of 1 U/kg body weight. Blood glucose measurements were repeated at every 20 min interval for 2 hours, using alternate hind limbs. During the intervals between blood samplings the mice are kept warm in regular cages.

Following insulin sensitivity test (IST), mice were euthanized.

WAT was collected and processed for the mRNA expression of key molecules involved in inflammation and insulin sensitivity.

The expression of P2Y 2-R in WAT was increased by 2-fold in HFD-fed WT mice (FIG. 17). Morphology of adipocytes in the white fat in wild-type and P2Y2 receptor knockout mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks is shown in FIG. 18. Feeding HFD to WT mice resulted in marked increase in the size and topology of adipocytes due to storage of excess fat. On the other hand, the increase in size of the adipocytes of KO mice is very low. Furthermore, the adipocytes in KO mice, whether fed control or HFD diet, had a tendency to accumulate low fat as evidenced by the “collapsed balloon-like” appearance vs. “inflated balloon-like” appearance in the WT mice.

FIG. 19 shows morphology of adipocytes in the BROWN FAT in wild type (WT) or P2Y2 receptor knockout (KO) mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks. As shown, feeding HFD to WT mice resulted in the accumulation of fat in the cells, as evidenced by increased number and size of vacuolar structures. On the other hand, the increase in size or number of the similar vacuolar structures is strikingly low in the HFD fed KO mice.

Whole-body insulin sensitivity were significantly higher in HFD fed KO mice vs. WT mice. FIG. 20 shows whole body insulin sensitivity in wild type (WT) or P2Y2 receptor knockout (KO) mice after feeding control (CNT) or high-fat (HFD) diets. The mice were challenged with a measured dose of insulin at 0 time point, and the fall in blood glucose was monitored every 20 min up to 2 hours. As shown, at 20, 40 and 60 min the HFD-fed KO mice showed significantly higher insulin sensitivity as compared to the HFD-fed WT mice. Furthermore, the mean basal levels of blood glucose (0 min) were also significantly lower in HFD-fed KO mice vs. HFD-fed WT mice.

Similarly, the mRNA expression of the insulin receptor, GLUT4 and IRS-1 (insulin receptor substrate-1) in WAT were significantly higher in HFD fed KO mice vs. WT mice, consistent with greater insulin sensitivity of HFD fed KO.

FIG. 21 shows Relative mRNA expression of insulin receptor (left panel) or glucose transporter type 4 (GLUT4) (right panel) in the white adipocytes of wild type (WT) or P2Y2 receptor knockout (KO) mice after feeding control (CNT) or high-fat (HFD) diets for 16 weeks. mRNA expression was determined by real-time RT-PCR. As shown, HFD-fed KO mice have significantly higher levels of expression of insulin receptor and GLUT4 compared to HFD-fed WT mice. These may contribute to better glucose tolerance and higher insulin sensitivity in KO mice.

On the contrary, the expression of pro-inflammatory molecules IL-6, MCP-1, CCR2, CD68 and F4/80 were significantly higher in WAT of HFD fed WT vs. KO mice. Our results demonstrate that KO of the P2Y 2-R is protective against diet-induced obesity and IR. The mechanisms may involve higher expression of insulin receptor signaling proteins, as well as reduced inflammation and lipotoxicity in the WAT of the KO mice.

Example 4: P2Y2 Receptor Knockdown

In addition to the use of agents such as a fusion protein, polypeptide, a small non-nucleic acid organic molecule, and a small inorganic molecule among other agents, that blunts the activity of a P2Y₂ receptor, the expression of P2Y2 receptor may also be blunted through the use of nucleic acid based agents, including an antisense oligonucleotide, a ribozyme or an inhibitory RNA, including but not limited to a small inhibitory RNA (siRNA) or a short hairpin RNA (shRNA). For example, P2Y2 receptor expression may be blunted or knocked down in adipocytes as well as other P2Y2 receptor-expressing cells of interest through delivery, including targeted delivery, of P2Y2 receptor siRNA(s) or alternatively P2Y2 receptor shRNA(s). Such methods are known in the art. For example, P2Y2 siRNAs and vectors/delivery system for expression of P2Y₂ shRNAs may be purchased from commercial vendors to knockdown P2Y2 receptor expression (Invitrogen, Carlsbad, Calif.; Santa Cruz Biotechnology, Santa Cruz, Calif.; OriGene Technologies, Rockville, Md. (e.g., catalog number: TR302717, TG302717, TL302717, TF302717, SR303327, TR501567, TG501567, TF501567, TL501567, SR412590, TR710051, TG710051, TL710051, TF710051, and SR514520; see also, Li W-H, Qui Y, Zhang H-Q et al. 2013. “P2Y2 receptor promotes cell invasion and metastasis in prostate cancer cells”. British Journal of Cancer 109:1666-1675).

Based on sequence for human P2Y2 receptor gene (NCBI Reference Sequence: NC_000011.10 for NCBI Gene ID 5029) and mRNA transcripts (NCBI Reference Sequence: NM_176072.2, NM_176071 and NM_002564), additional siRNA and shRNA may be designed to knockdown the P2Y2 receptor gene expression, and hence reduce P2Y2 receptor activity in a cell. Other agents that may be designed and used to knockdown P2Y2 receptor gene expression include anti-sense oligonucleotide, ribozyme, and miRNA among others. In addition, based on P2Y2 receptor gene sequences at publically accessible databases such as databases at the National Center for Biotechnology Information (Bethesda, Md.), agents that knockdown gene expression may be designed and used to target P2Y2 receptor gene expression in other mammalian species, including as mouse and rat. For example, GE Healthcare Dharmacon Inc. (Lafayette, Colo.) provides 63 siRNA products and 103 shRNA products as reagents directed to knockdown activity of species specific P2Y2 receptor, such as human, mouse and rat (e.g., Catalog Number: E-003688-00-0005; EU-003688-00-0002; EQ-003688-00-0002; E-040991-00-0005; EU-040991-00-0002; EQ-040991-00-0002; E-091224-00-0005; EU-091224-00-0002; EQ-091224-00-0002; VGH5526-EG5029; RHS5086-EG5029; RHS4531-EG5029; VGH5518-200220583; VGH5518-200224821; VGH5526-EG18442; RHS4287-EG18442; RMM4532-EG18442; RHS5089-EGI8442; V3SM7677-01EG18422-V3SM7671-231571660; V3SR7679-01EG29597; V3SR7673-238013458; V3SR7673-238450774). Agents that knockdown gene expression include anti-sense oligonucleotide, ribozyme, siRNA, shRNA and miRNA among others.

The above description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles described herein can be applied to other embodiments without departing from the spirit or scope of the invention. Thus, it is to be understood that the description and drawings presented herein represent a presently preferred embodiment of the invention and are therefore representative of the subject matter which is broadly contemplated by the present invention. It is further understood that the scope of the present invention fully encompasses other embodiments that may become obvious to those skilled in the art and that the scope of the present invention is accordingly not limited. 

What is claimed is:
 1. A method for treating diet-induced obesity in an obese subject or a subject at risk of diet-induced obesity comprising administering an agent in an effective amount so that expression or activity of the P2Y2 purinergic receptor is decreased or inhibited in the subject, thereby treating diet-induced obesity in the obese subject or the subject at risk of diet-induced obesity.
 2. The method of claim 1, wherein the agent comprises a P2Y2 receptor antagonist.
 3. The method of claim 2, wherein the P2Y2 receptor antagonist is a non-selective or slightly selective P2Y2 receptor antagonist.
 4. The method of claim 2, wherein the P2Y2 receptor antagonist is a selective or specific P2Y2 receptor antagonist.
 5. The method of claim 3, wherein the non-selective or slightly selective P2Y2 receptor antagonist is an isolated organic molecule or isolated inorganic molecule.
 6. The method of claim 5, wherein the isolated organic molecule is an isolated organic molecule from a plant or an isolated flavonoid.
 7. The method of claim 6, wherein the isolated organic molecule from a plant or an isolated flavonoid is strobopinin, strobopinin-7-methyl ether, 2′-β-Dihydroxy-4′,6′-dimethoxy-3′-methylchalcone (or Oxo-Aurentiacin), kaempferol, heptamethoxylflavone, or tangeretin.
 8. The method of claim 5, wherein the isolated organic molecule is an isolated organic molecule produced by synthetic chemistry, biochemistry and/or an enzymatic method.
 9. The method of claim 8, wherein the enzymatic method is performed in vitro or in a genetically engineered microorganism.
 10. The method of claim 3, wherein the non-selective or slightly specific P2Y2 receptor antagonist is AR-C126313, or AR-C118925 (5-[[5-{2,8-dimethyl-5H-dibenzo[a,d]cyclohepten-5-yl}-3,4-dihydro-2-oxo-4-thioxo-1(2H)-pyrimidinyl]methyl]-N-[1H-tetrazol-5-yl]-2-furancarboxamide).
 11. The method of claim 5, wherein the isolated organic molecule has a molecule weight of less than 1,500 daltons.
 12. The method of claim 1, wherein the agent comprises a polypeptide.
 13. The method of claim 12, wherein the polypeptide is a fusion protein, an antibody, a polyclonal antibody, a monoclonal antibody, an antigen-binding fragment of an antibody, a Fab antibody fragment, a F(ab′)₂ antibody fragment, a Fv antibody fragment, a single chain variable fragment (scFv), or a bispecific antibody.
 14. The method of claim 13, wherein the antibody, the polyclonal antibody, the monoclonal antibody, the antigen-binding fragment of an antibody, the Fab antibody fragment, the F(ab′)₂ antibody fragment, the Fv antibody fragment, the single chain variable fragment (scFv), or the bispecific antibody inhibits the activity of P2Y2 receptor.
 15. The method of claim 1, wherein the agent comprises a nucleic acid.
 16. The method of claim 1, wherein the agent comprises a system for targeted disruption or knockdown of the P2Y2 receptor gene in a living cell.
 17. The method of claim 16, wherein the system comprises a delivery system or expression system for antisense oligonucleotide, ribozyme or an inhibitory RNA.
 18. The method of claim 17, wherein the inhibitory RNA is selected from the group consisting of an siRNA, shRNA and miRNA.
 19. The method of claim 1, wherein the agent increases expression or activity of one or more peroxisome proliferator-activated receptor (PPAR) genes in brown fat.
 20. The method of claim 19, wherein the PPAR gene is selected from the group consisting of PPAR-δ and PPAR-γ.
 21. The method of claim 19, wherein the PPAR gene is PPAR-γ.
 22. The method of claim 1, wherein the agent increases expression or activity of one or more uncoupling protein (UCP) genes in brown fat.
 23. The method of claim 22, wherein the UCP gene is selected from the group consisting of UCP-1, UCP-2 and UCP-3.
 24. The method of claim 22, wherein the UCP gene is UCP-1.
 25. The method of claim 1, wherein the agent decreases expression or activity of pro-inflammatory genes in white adipose tissue.
 26. The method of claim 25, wherein the pro-inflammatory genes are selected from the group consisting of interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1 or CCL-2), monocyte chemoattractant protein-1 receptor (CRR2), monocyte/macrophage cluster differentiation 68 protein (CD68), a defining marker of murine macrophage F4/80 and combination thereof.
 27. The method of claim 1, wherein the agent increases expression or activity of insulin receptor substrate-1 (IRS1) in white fat.
 28. The method of claim 1, wherein the agent increases or maintains expression or activity of insulin receptor, glucose transporter type 4 (GLUT4) or a combination thereof.
 29. A method for increasing energy metabolism in an adipocyte cell in a subject that is at risk for or suffering from a disorder related to glucose metabolism, the method comprising administering to the subject an agent that inhibits expression or activity of a P2Y2 receptor, thereby increasing the metabolism in the cell. 